Medical marijuana documents available on Cape

SOUTH DENNIS - More than half a dozen prospective patients waited in the parking lot Friday for the grand opening of Canna Care Docs, a physician practice that specializes in certifying patients for medical marijuana use.

State Department of Public Health officials say some but possibly not all of the state's 20 provisionally approved medical marijuana dispensaries will be open by this summer.

The DPH is in ...

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WHERE'S THE DISPENSARY?

State Department of Public Health officials say some but possibly not all of the state's 20 provisionally approved medical marijuana dispensaries will be open by this summer.

The DPH is in the process of meeting “face to face” with dispensary officials as part of the final approval process, Karen van Unen, executive director of the DPH Medical Marijuana Program, said in an editorial board meeting at the Cape Cod Times Friday.

“No final decisions have been made,” she said. The process may be “faster or slower” depending on dispensary progress in working with town officials, contractors and financial backers, she said.

But van Unen expects dispensaries to start opening this summer.

“It's very important to us we don't drag out this process,” she said. “We're anxious to meet the needs of the patients.”

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SOUTH DENNIS - More than half a dozen prospective patients waited in the parking lot Friday for the grand opening of Canna Care Docs, a physician practice that specializes in certifying patients for medical marijuana use.

“It's about time,” a woman said as she walked up to the steps at 708 Route 134. Eight patients gathered outside as staffers and vendors hurriedly stocked industry-related magazines and a display of vaporizers before opening the doors at 2 p.m.

About 2 1/2 hours later, Robert Foley, 36, of Dennis emerged with a written certification on Canna Care Docs letterhead entitling him to medical marijuana.

“I'm psyched. I'm really psyched,” Foley said.

Smoking marijuana helped save Foley's life when he had Hodgkins lymphoma several years ago, he said. His new legal certification will help him combat nerve pain from a titanium rod in his back, he said.

The new walk-in clinic is located just four miles from where a medical marijuana dispensary, Barnstable County Wellness Center, plans to start operations this summer.

“There's going to be a large demand on the Cape,” Michael Maloney of Maloney and Associates in Attleboro, the attorney for Canna Care Docs said. “There's no other convenient location providing the services we are.”

A Massachusetts law passed by voters in November 2012 allows qualifying patients to get certifications to purchase from state-approved marijuana dispensaries. In late January, the state gave provisional approval to 20 dispensaries, including two on the Cape - the Barnstable County Wellness Center and Medical Marijuana of Massachusetts in Mashpee.

Some dispensaries may open as early as this summer, according to officials from the state Department of Public Health. In the meantime, certified patients may grow their own or get marijuana from “caregivers.”

But with physicians at many large Cape organizations saying they won't certify patients for medical marijuana, outside practices that specialize in certifying patients for cannabis use are moving in.

Canna Care Docs already has five other locations: one each in Stoughton, Seekonk and Worcester and two in Boston.

An organization called Integr8 Massachusetts also is considering setting up shop on the Cape, its CEO Brad Feuer. The parent group has two practices in Maine and one in Illinois.

Integr8 Massachusetts recently opened a location in Burlington, he said.

“We actually get a lot of patients from the Cape coming to see us,” Feuer said. He did not say how many.

Dozens of Cape patients seeking certifications also have trekked to Canna Care's offices off-Cape and Delta9 Medical Consulting in Metheun, according to the practices.

Dr. Harold Altvater, an anesthesiologist who operates Delta9, said he has seen about 30 patients from the Cape.

Canna Care in Dennis will employ two doctors for starters, but Maloney would not name them nor would he release the names of the practice's owners.

Doctors certifying patients for medical marijuana eventually will be required to register with the state Department of Public Health, but the registration process hasn't started yet and the state does not yet have a list of certifying doctors, DPH spokeswoman Anne Roach said.

“The system is expected to be up and running by late spring/early summer,” she said in an email.

Foley said smoking marijuana - in combination with taking the legal synthetic cannabinoid marinol - was the only thing that quelled his nausea and boosted his appetite when he was treated for Hodgkins lymphoma several years ago. Now, he hopes it will help his back pain.

He said he spent 30 to 45 minutes with the staff at Canna Care Docs, not counting the wait time.

“They were professional. They were very nice,” he said. “They finally listened to me.”

Doctors not only write certifications, they also advise patients on what kinds and what sort of delivery system to use: vaporizer, edible, tincture or topical paste, she said.

The growth of physician practices that specialize in certifying patients for medical marijuana use concerns Dr. Ronald Dunlap of Weymouth, president of the Massachusetts Medical Society.

DPH regulations says certifying doctors must have a “bona fide” medical relationship with patients, but Dunlap said physician certifiers are in business for one purpose only.

“You're essentially just an access point for (medical) marijuana. I couldn't do that for morphine or Percocet,” Dunlap said. “These people have a business plan that's been in place for years to do this. It's an issue for us.”

The Massachusetts Board of Registration in Medicine and the DPH have yet to indicate whether single-purpose clinics are an appropriate method of certifying patients for medical marijuana, said Dunlap, a cardiologist.

It is not within the purview of the DPH to regulate physicians, but the state agency will create a customer service team that will pass concerns about the certifying physicians along to the appropriate organizations, Karen van Unen, executive director of the DPH medical marijuana program, said Friday.

State officials are reaching out to doctors in regular practice to address their concerns about medical marijuana, she said during an editorial meeting with the Times on Friday.

Some of the patients lining up at Canna Care Docs Friday clutched manila envelops or CDs containing their medical records; others appeared to be empty-handed.

It is recommended that patients take their medical records to appointments, but it's not required, Maloney said. He said visits cost $200, he said.

Integr8 also charges $200 for the first visit, Feuer said.

Once dispensaries are open for business, the process of certifying patients will become more formal, van Unen said.

Patients will be issued a registration card with a photo ID and an identification number that dispensaries can cross reference, she said.

Doctors will indicate how long a patient is eligible within a time range from 15 days to one year.

Patients will be allowed to purchase up to 10 ounces of medical marijuana every 60 days, van Unen said. However, the prescribing doctor can specify a larger amount if he or she deems it appropriate, she said.

And as of July 1, certifying physicians will be required to have two hours worth of continuing medical education credit in medical marijuana, van Unen said.

Altvater said he took a course in medical marijuana in Washington, D.C., from University of California researchers.

He said this fall he sent the state information he needs to be registered - including his physician license number and controlled substance registration number - but he hasn't heard anything back.

Van Unen said state officials are working on getting the physician registration program up and running.